1235865189 NPI number — M.S. SHARIFF, M.D., P.A.

Table of content: (NPI 1235865189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235865189 NPI number — M.S. SHARIFF, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M.S. SHARIFF, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235865189
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 AURORA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21613-1903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-228-4902
Provider Business Mailing Address Fax Number:
410-228-3009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 BYRN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21613-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-221-7770
Provider Business Practice Location Address Fax Number:
410-221-7863
Provider Enumeration Date:
07/25/2022

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
CARRIE
Authorized Official Middle Name:
F
Authorized Official Title or Position:
CREDENTIAL STAFF
Authorized Official Telephone Number:
410-228-4902

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 524000000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com